Evaluating Sleep Health in National Surveillance Systems: Gaps, Tools, and Strategies for Improved Monitoring

Abstract

Introdcution Sleep health is a multidimensional framework that contains several distinct but related domains. The integration of sleep health into public health surveillance systems is limited. Therefore, the aims of the thesis were to i) evaluate the current state of national surveillance systems in monitoring the sleep health of adults and ii) identify and assess the suitability of available tools for measuring sleep health in national surveillance systems.

Methods

A scoping review was conducted in Chapter 3 to identify existing national surveillance systems monitoring sleep health. Chapter 4 examined associations between sleep health indicators and sociodemographic factors and health conditions using cross-sectional data from the Australian Health Survey. Finally, in Chapter 5, a systematic review was carried out to identify and evaluate the validity and reliability of sleep assessment tools for use in health surveillance.

Results

Chapter 3 revealed that national sleep health surveillance was conducted in only 51 out of 199 countries examined. There was also a large disparity in surveillance between high-income and low- and middle-income countries. In Australia, surveillance only captured two sleep-related indicators: sleep duration and sleep medication use. Chapter 4 revealed that 16.8% and 15.4% of Australian adults experience short and long sleep, respectively, while 16.7% of adults with a long-term mental health condition used sleep medications for more than six months. Furthermore, sleep duration and sleep medication use were not significantly associated with chronic health conditions. Finally, Chapter 5 identified 57 sleep assessment tools that had been partially validated in general population samples and only two tools measured all domains of sleep health.

Conclusion

Overall, the thesis provided several practical and policy-related strategies and suggestions for future research to improve the monitoring of sleep health in national surveillance systems.